Adjuvant effects of the fascial distortion model in patients with temporomandibular disorders: A multi-centered randomized controlled clinical trial

This study aimed to compare the effects of the fascial distortion model with the Pilates method or control in patients with temporomandibular disorders. The intervention groups received one of these two methods in addition to the conventional home program (patient education and Rocabado's 6x6 home exercises), while the control group did not receive any treatment. Fifty-four patients (eighteen per group) were recruited for eight weeks. Pain intensity was measured with the revised graded chronic pain scale, shortform McGill pain questionnaire, visual analog scale, and numerical pain rating scale. Head posture was assessed by photogrammetry. Maximum pain-free mouth opening, maximum possible mouth opening, maximum assisted mouth opening, laterotrusions, and protrusion were measured using a digital vernier caliper. Temporomandibular disorder severity, dysfunction, disability, and quality of life were assessed by the Fonseca anamnestic index, the mandibular function impairment questionnaire, the craniofacial pain and disability inventory, and the cognitive exercise therapy approach-biopsychosocial questionnaire, respectively. The group-by-time interaction effect was only statistically significant for right laterotrusion (F = 4.66, p = .012), left laterotrusion (F = 3.703, p = .034), pain intensity in the last week according to the numeric pain rating scale and the short-form McGill pain questionnaire (χ² = 2.84e+6, p < .001; F = 4.158, p < . 001; respectively), present pain intensity according to the visual analog scale and the index on the short-form McGill pain questionnaire (F = 5.078, p < .001; χ² = 29.74, p < .001; respectively), temporomandibular disorder severity (F = 3.38, p = .044), and disability in jaw functional status (F = 3.4721, p = .044). Once-per-week sessions of the fascial distortion model, combined with the conventional home program, clinically and/or statistically significantly improved maximum pain-free mouth opening, laterotrusions, present pain intensity, and pain intensity in the last week, temporomandibular disorder severity, dysfunction, and disability.